Study Finds Antibiotics Ineffective for Coughs

A recent study has found that the use of antibiotics to treat persistent coughs (not caused by pneumonia) is ineffective.

The European study involved 2,061 patients with acute lower-respiratory-tract infections where pneumonia was not suspected, and the patients were randomised to receive either amoxicillin or a placebo.

The findings showed that neither the duration of those symptoms considered ‘moderately bad’ or worse nor their severity varied between the two groups.

New or worsening symptoms were found to be considerably less common in patients receiving amoxicillin in comparison to those in the control arm.  However, cases of nausea, rash, or diarrhoea were more common in patients taking the antibiotic.

The patients, who were spread across 12 different European countries, filled in an ‘illness diary’ to track their recovery.  Within the daily diary, the patients rated the severity of their symptoms including cough, shortness of breath, chest pain, and blocked or runny nose.

Based on the result data, the researchers concluded that when pneumonia is not suspected, “amoxicillin provides little benefit for acute lower-respiratory-tract infection in primary care both overall and in patients aged 60 years or more, and causes slight harms.”

Previous research into whether or not antibiotics are beneficial in the treatment of chest infections, have produced contradictory outcomes- particularly in older people where chest infections can lead to further complications.

The results are especially pertinent as a result of the recent focus on controlling the extensive use of antibiotics in primary care.

Overuse of Antibiotics

“Overuse of antibiotics, which is dominated by primary care prescribing, particularly when they are ineffective, can lead to side effects such as diarrhoea, rash, vomiting and the development of resistance,” commented the lead study author Paul Little, Professor of Primary Care Research at the University of Southampton.

“Our results show that most people get better on their own. But, given that a small number of patients will benefit from antibiotics the challenge remains to identify these individuals,” he added.

“Guidance from measurements of specific blood biomarkers of bacterial infection might help to identify the few individuals who will benefit from antibiotics despite the apparent absence of pneumonia and avoid the toxic effects and costs of those drugs and the development of resistance in the other patients,” noted Philipp Schuetz from the University of Basel in Switzerland.

Last month Chief Medical Officer Professor Dame Sally Davies cautioned that antibiotics are losing their effectiveness “at a rate that is both alarming and irreversible,” and she asked patients and prescribers “to think about the drugs they are requesting and dispensing.”

Links:
www.lancet.com
www.pharmatimes.com
www.bbc.co.uk

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